2002-1018 / "
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804.5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERT IFICAT E OF COMPLIANCE
Permit Number: P20021018 'Date Issued: Wednesday,January 08,2003
This is to certify that work requested to be done as shown by Permit Number P20021018
has been completed.
Tax Map Number: 523400-296-014-0001-007-000-0000
Location: 78 MONTRAY Rd
Owner: GRAYSON PROPERTIES LLC
Applicant: GRAYSON PROPERTIES LLC
This structure may be occupied as a:
By Order of Town Board
Septic Alteration Residential TOWN OF QUEENSBURY
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12.804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20021018 Application Number: A20021018
Tax Map No: 523400-296-014-0001-007-000-0000
Permission is hereby granted to: GRAYSON PROPERTIFS I.T.0
For property located at: 78 MONTRAY Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Tyve of Construction Value
Owner Address: GRAYSON PROPERTIES LLC Septic Alteration Residential
1004 CHESTNUT St Total Value
MECHANICVILLE,NY 12118
Contractor or Builder's Name/Address Electrical Inspection Agency
IBS SFPTIC &DRAIN
ATTN: IVAN 13FT.T.
2 LOWFR WARRFN St
OIJF-,F,NSBIJRY.NY 12804
Plans&Specifications
2002-1018 Lot 1B
Residential septic alteration per plot plan and specifications.
$25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,December 16,2003
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To of u ens cember 16,2002
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Application for Permit—Septic Disposal System
Town of Queensbury 742 Bay Road Queensbury, IVY 12804 (518) 761-8256
?�4
1. OWNER INFORMATION: 7
Offlice Use
#Location of installation:
File Permit No. -Lc-)(s 6 1
Tax Map No.
Fee Paid
Owners Nam.: -. ClK r r
..................... ................................................... ......................
Address:
2. INSTALLER'S NAME Cr.0 7 C PHONE NO.
3. RESIDENCE INFORMATION: (circle year of dwelling,indicate#bedroom(s) and multiply# of
bedrooms with applicable gallons per bedroom to equal total daily flow)
Year of House: No. of Bedrooms is Computation = Total Daily Flow
1980 or older x 150 gal/bdnn = 6
1980- 1991 x 130 gal/bdrm =
1991 -present x 110galfbdrm = RECENED
Garbage Grinder Installed yes_ no >�- DEC I ? 2002
Spa or Whirlpool Installed yes— no
TOWN OF QUEENSBURY
BUILDING AND CODE
4. PARCEL INFORMATION: (circle applicable information &indicate measurements)
gmp-hy SqP5NgLture Ground Water Bedrock or ImRervious Material m ater SW ply
Flat (sand at what depth a�t w at epth municipal
'- ingfeet eel
Steep slope clay if well;water supply
%slope other from any septic-system
depth: absorption is
other
Percolation Test: (To be completed by licensed professional engineer or architect)
minute per inch-
5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by a licensed
professional engineer or architect(unless installed in a Planning Board approved subdivision). Add 250 gallons to the size
of the septic tank and leach field for each Garbage Grinder,_Spa or Whirlpool Tub.
Septic Tank: gallon (min,-size 1,000 gal.)
Tile Field: each trench ft Total System Length: ft
Seepage Pit(s): number of size ofeach: —ft. by _ft.
Size of Stone to be used: depth or thickness feet
Bed System Size: x
Alternative System: length and/or size
6. HOLDING TANK-SYSTEM: (if required)
Number oftanks: Size of each:_gallons /TOTAL Capacity:_gallons
Note: Alarm System and associated electrical work-must be inspected by a Town approved
electrical inspec Lion agency.
7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read)
For your protection,please note that pursuant to Section 136-29 ofthe Code of the town
of Queensbury,any permit or approval granted which is based upon or is granted in
reliance upon any material misrepresentation or failure to make a material fact or
circumstance known by or on behalf of an applicant, shall be void.
I have read the regulations with respect to this application and agree to abide by these and all
requirements of the wn of Queensbury Sanitary Sewage Disposal Ordinance.
ae
Signature of resp6hifble Werson Date
. � 'ii>'wrt of CZtrccrral>•ui-y .
atrrtI sewage Disposal CI1.1ptrr•
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7. SIGNATLTRL- 8c INFORMATION FOR RESPUNblzj r.r=z47wrtN i, AP---_•..,:; {
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Septic Inspection Report
Office No. (518)761-8256 Date inspection request received:
QueensburyBuilding&Code Enforcement Arrive: to Y" am/pm . Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
NAME: PERMIT NO.: / V
INSPECT ON:
LOCATION:
RECHECK:
Comments and/or diagram
Soil Type: SandAo lay
nTe of Water: &—Udiei 1/Well Water
Waterline separaOon-distance
Well separation distance
Other wells: ft.
Absorption Field: Total length ft.
Length of each trench 2. ft.
Depth of trenches
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
Piping Size Type
Building to tank q,
Tank to Distribution Box
Distribution Box t ield Pit 5D A-
Opening Sealed: CYJIN/Partial
Location/Separations
Foundation to tank ft.
Foundation to absorption ft.
Separation of Pits ft.
Conforms as per Plot Plan Y N
Location of System on Property:
Front Rear Left Side Right Si
Middle Front Middle Rear
System Use Status:
Approved
Partial Approved and needs to be re-inspected,please call the Building&Codes Office
Disapproved
I have seen or observed, or believe I saw evidence of,
ajl obiects such as houses, wells,,trees, fences, etc., D 0 1D
-sshown on this document. I also represent that I have �
j D rsonali' easured the distances set forth ors the diagram."
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p
SIGNATURE DATE
RECEIVED
t
DEC 12 2002
TOWN OF QUEENSBURY
BUILDING AND CODE
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BUILD N. & O ES EIT.
REVIEWED
DATE /rt
SUBSURFACE INVESTIGATION
7
SOIL CONDITIONS ON LOT #lB SIMILAR TO SOIL FOUND ON BOTH #15& #19 T
WITH IN THE MONTRAY HEIGHTS TRAILER PARK.
UTILITY POLE-\ SOIL: REDDISH YELLOW FINE SAND (GROUNDWATER >8') Z
4" PVC EFFLUENT LINE; PERCOLATION RATE: 1 5 MINUTES PER INCH T o w O�
1% MIN. SLOPE ¢ o
T-
APPROXIMATE
DISTRIBUTION BOX 2
DI 11000 CA POLY
/Aa7sEPTIC TNNK
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4 PVC DISTRIBUTOR LINES;
0.5% MIN. SLOPE (TYP.) o/ Z
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DESIGN INFORMATION:
16" DBH OAK TREE- 04 2 1 1
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(NO ROOTS WERE REMOVE DESIGN BASIS R
TO INSTALL LEACHING FIELD) NEW YORK STATE DEPARTMENT OF HEALTH I a
7i) TOWN OF QUEENSBURY R
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4" PVC BUILDING SEWER; POTABLE WATER SUPPLY o Z Z
2% MIN. SLOPE NO DOCUMENTED POTABLE WATER SUPPLY SOURCES
LOCATED WITHIN 100 FT. OF PROPOSED WASTEWATER DISPOSAL
SYSTEM. LOT #IB AND THE NEIGHBORING TRAILERS ARE SERVED BY A
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MUNICIPAL WATER SYSTEM.
DESIGN FLOW
D:: RESIDENCE
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-1 2 BEDROOMS x 150 GPD/BEDROOM = 300 GPD
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SEPTIC TANK U H
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1000 GALLONS (MIN.) CAPACITY FOR 2 BEDROOM RESIDENCE
0 NEW 1000 GALLON SEPTIC TANK PROVIDED. z c/)
LEACHING SYSTEM (FIELD) 0
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x 300 GPD + 1.2 GPD/SQ. FT. = 250 SO. F7. REQ'O 0 z 0
= to(1-5 MINUTE/INCH PERCOLATION RATE IN SITU SOIL) z 0-
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250 SO. FT. - 2' WIDE TRENCH = 125' MINIMUM OF > 0 z
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"EQUALIZER 24'" INFILTRATOR TRENCH REQUIRED. Cc m ED zi�
(3) LATERALS Li,EACH 42.15' FT. LONG REQUIRED n z
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('EQUALIZER 24"INFILTRATOR LATERALS EACH (5) UNITS LONG) 0 75 tz <
ACTUAL CAPACITY OF CONSTRUCTED LEACHING SYSTEM ¢ Lo
(3) LATERALS x 42.15' PER LATERAL = 126.45' OF TRENCH PROVIDED Z
126.45' x 2' WIDE TRENCH = 252.9 SQ. FT. > c/)
OF ABSORPTION AREA PROVIDED ¢ C/) I- z
252.9 SQ, FT. x 1�2 GPD/SQ. Fr. (APPLICATION RATE) z 0 8
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151-01, = 303,48 CPS DESIGN CAPACITY 5
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EFFLUENT DISTRIBUTION
GRAVITY DOSING/DISTRIBUTION VIA"D-BOX" FROM SEPTIC TANK.
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SPEED LEVELERS INSTALLED IN D-BOX 12:45 PM 1/8/03, OBSERVED w
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GRAPHIC SCALE
STOCAKADE FENCE Cc. 10 0 5 10 20 40
IN FEET
SCALE: 1" = 10'
WASTEWATER PLAN
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GRADED TO DRAIN AWAY i �Cb
TWIST LOCK ACCESS FROM SEPTIC TANK
COVER (TYP.)
FINISHED GRADE ZW
0
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12"±
BUILDING SEWER
3"
INLET OUTLET
NATIVE BACKFILL—,,, 15" 18"
THOROUGHLY COMPACTED EFFLUENT LINEia
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12" OF CRUSHED STONE —�- `1000 GAL. Z
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POLY SEPTIC TANK
OR BEDDING SAND FOR
FOUNDATION
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POLY SEPTIC TANK DETAIL
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TREATED LUMBER MARKER U) im cc) �3�
/-ABOVE ALL BURIED COVERS; I Lu; b-
SET 1/2" ABOVE GRADE 66
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PROVIDE ADJUSTABLE LEVELING 0 m
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INLET 0
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DEVICE V'
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12" MIN. OF CLEAN SAND
2" MIN. ✓ OR PEA GRAVEL FOUNDATION
FORT MILLER DISTRIBUTION c�
OUTLETS 4" KNOCKOUTS BOX OR EQUIVALENT
_DISTRIBUTION BOX DETAIL